About the Esophageal Program
The Esophageal Program at the Massachusetts General Hospital Division of Thoracic Surgery employs a variety of minimally invasive and traditional surgical approaches to comprehensively treat esophageal diseases. Conditions include:
- Benign esophageal tumor
- Esophageal cancer
- Esophageal reflux
- Paraesophageal hernia
The Division of Thoracic Surgery has board-certified thoracic surgeons with decades of institutional and individual experience. We create an individualized treatment approach for each patient and often work together with physicians from other medical specialties to treat the most challenging patients and conditions.
To ensure safe and effective care, the Department of Surgery tracks many performance measures and compares them to national data, including esophagectomy for cancer outcomes and patient ratings of thoracic surgeons.
View our surgical outcomes compared to national data
Cancer of the Esophagus & Esophagogastric Junction
Esophageal cancer presents in two main forms: squamous cell carcinoma and esophageal adenocarcinoma.
All patients will meet with a surgeon before treatment. Patients with early esophageal cancer first undergo surgical removal of the cancer, while patients with locally advanced cancers generally receive chemotherapy and radiation before surgery. We choose the most appropriate surgical approach for esophageal cancer based on the disease and the patient’s needs. Generally, these procedures involve removing all or part of the esophagus and some of the surrounding tissue. They are:
- Minimally invasive esophagectomy—a leading-edge procedure using multiple small incisions made in the chest and the abdomen with camera visualization
- Standard esophagectomy—a time-tested open procedure with incisions made in the chest and abdomen
Benign Conditions and Procedures of the Esophagus
Our division offers diagnostic and therapeutic management of benign esophageal diseases. The majority of our patients with benign esophageal conditions can be treated with minimally invasive laparoscopic or thoracoscopic procedures. These allow our patients to enjoy a significantly quicker recovery.
The conditions we treat and procedures we perform include:
The failure of muscle fibers to relax, which prevents the esophagus from squeezing food into the stomach. Achalasia is treated by laparoscopic Heller myotomy, which is a technique in which an incision is made in the muscle of the esophagus to relieve the difficulty with swallowing food.
A condition affecting the lining of the esophagus, the swallowing tube that carries food and liquids from the mouth to the stomach. Barrett’s esophagus is a change in the lining of the esophagus from a normal, white lining to a pink/red lining.
Benign (Non-Cancerous) Tumor
Colon and Jejunal Interposition for Complex Esophageal Reconstruction
Our division is a leading referral center for complex reconstruction following complicated prior reconstruction after esophagetomy.
Dividing the muscles of the cricopharyngeal muscle (muscle encircling the upper end of the esophagus) to relax it and allow food to pass.
Growths in the lining of the esophagus that can cause difficulty with swallowing and breathing.
A pouch that branches out from the esophageal lining between the throat and the stomach, such as Zenker's diverticulum. Esophageal diverticulum is treated by removing the pouch from the esophageal lining.
Gastroesophageal Reflux Disease (GERD)
A digestive disorder that is caused by gastric acid flowing from the stomach into the esophagus. GERD is treated by laparoscopic fundoplication which is a technique in which the stomach is wrapped around the outer (distal) esophagus to treat severe acid reflux. Anti-reflux surgery can also be performed. Our division is a referral center for patients that have problems after prior reflux surgery which is called re-operative gastroesophageal reflux surgery.
Occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm.
Treated by either a laparoscopic or trans-thoracic approach, which is used to restore the normal abdominal position of a stomach that has herniated into the chest.
Each patient's situation is unique and requires careful consideration of many factors to determine the best treatment options and care team for his or her esophageal disease. We work collaboratively with surgeons in Mass General’s Swallowing, Heartburn and Esophageal Disease (SHED) Center, who specialize in complex surgical techniques to treat patients with esophageal cancers or other non-cancerous esophageal conditions. We also work closely with our colleagues in medical oncology and radiation therapy in treating esophageal cancer. If a patient has other diseases in addition to the esophageal disorder, we involve additional world-class Mass General specialists—cardiologists, pulmonologists, anesthesiologists, pain medicine specialists and others—to help the patient safely through the procedure and back to health.
As a first step, new patients meet with one of our thoracic surgeons to determine the most effective course of treatment and whether further evaluation is needed.
If additional evaluation by an oncologist and radiotherapist is needed, we may refer patients with esophageal cancer to the Mass General Cancer Center’s multidisciplinary clinic. Typically, multimodality therapy (i.e., surgery following radiation therapy and chemotherapy) produces the greatest benefit for patients with locally advanced esophageal cancer.